Provider Demographics
NPI:1275714354
Name:MARKOWSKY, VINCE THOMAS (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:VINCE
Middle Name:THOMAS
Last Name:MARKOWSKY
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9458 BARTEL RD
Mailing Address - Street 2:
Mailing Address - City:BREWERTON
Mailing Address - State:NY
Mailing Address - Zip Code:13029-9649
Mailing Address - Country:US
Mailing Address - Phone:315-409-6993
Mailing Address - Fax:
Practice Address - Street 1:9458 BARTEL RD
Practice Address - Street 2:
Practice Address - City:BREWERTON
Practice Address - State:NY
Practice Address - Zip Code:13029-9649
Practice Address - Country:US
Practice Address - Phone:315-409-6993
Practice Address - Fax:315-598-8799
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-17
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070654-1R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical